| NPI | 1407524911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37594) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS043295) |
| 163W00000X Registered Nurse (Licence: NY 722976) | |
| 163W00000X Registered Nurse (Licence: TX 1043164) | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-08-31 |